乙型肝炎病毒相关性肾炎的临床病理研究  

THE CLINICAL AND PATHOLOGICAL STUDY OF HEPATITIS B VIRUS ASSOCIATED GLOMERULONEPHRITIS

作　　者：许冬梅[1] 任万华[1] 谭燕泉[2] 赵洪涛[1] 刘遵昌[1] 周庚寅[2] 

机构地区：[1]山东省立医院内科 [2]山东医科大学病理学教研室

出　　处：《山东医科大学学报》1999年第3期192-195,共4页Acta Academiae Medicinae Shandong

基　　金：山东省卫生厅科研基金

摘　　要：对 ４４ 例 Ｈ Ｂ Ｖ 抗原血症并有尿检异常的患者进行了临床及肝、肾经皮活检病理研究，用 Ｐ Ｃ Ｒ 法检测肾组织中的 Ｈ Ｂ Ｖ Ｄ Ｎ Ａ，根据结果分组进行治疗观察。结果表明， Ｈ Ｂ Ｖ 相关性肾炎发病率为６５９％ （２９／４４）。２９ 例中膜性肾病 １３ 例，膜增殖性肾炎６ 例，系膜增殖性肾炎１０ 例。肾组织中 Ｈ Ｂ Ｖ Ｄ Ｎ Ａ 检出率为７２４％ 。慢性活动性肝炎并 Ｈ Ｂ Ｖ 相关性肾炎发病率高，用激素及干扰素配合治疗效果好。提示 Ｈ Ｂ Ｖ可通过多种机制引起肾损害， Ｈ Ｂ Ｖ 抗原血症并尿检异常并非全是 Ｈ Ｂ Ｖ 相关性肾炎。In order to investigate the relationship between HBV and the glomerulonephritis(GN) occurrence, the correlation of hepatic and renal disease, 44 HBV carriers with abnomal urinoanalysis were analyzed for clinical abnormalities as well as histopathological changes of livers and kidneys. Polymerase chain reaction (PCR) was applied to detect HBV DNA in the renal biopsy samples. The incidence of HBV associated GN is 65.9%(29/44) among this group of patients. Membrane nephropathy is found in 13 cases, while 10 cases are manifested with mesangial proliferative GN and 6 with membranoproliferative GN. HBV DNA is positive in the renal tissue of 21 cases. There is a high incidence of HBV associated GN among patients with chronic active hepatitis. Combined treatment with corticosteroid and Alfa interferon is effective for HBV associated GN. HBV may cause renal damage through different mechanisms. Not all HBV carriers with abnormal urinoanalysis is HBV associated GN.

关 键 词：肾小球肾炎 乙型肝炎病毒 病理学 

分 类 号：R692.310.2[医药卫生—泌尿科学]